title: Teaching humanistic and psychosocial aspects of care: current practices and attitudes.
abstract: OBJECTIVE
  To assess current practices and attitudes toward teaching humanistic and psychosocial aspects of care in internal medicine residency programs.
  
  
  METHODS
  Survey questionnaires were sent to residency directors at all 434 internal medicine residency programs accredited in 1985-1986. Response rate for two mailings was 71%.
  
  
  RESULTS
  78% OF RESIDENCY DIRECTORS and 70% of department chairpersons had high or moderately high levels of commitment to teaching humanistic/psychosocial aspects of care, but only 44% of responding programs offered mandatory training, and only 18% offered elective training in these areas. Obstacles to expanded teaching of the humanistic/psychosocial aspects rated high or moderately high by residency directors included insufficient curriculum time (51%), lack of trained faculty (44%), and pressures to reduce both training costs (40%) and patient-care costs (37%).
  
  
  CONCLUSIONS
  Most of the training that does occur in the humanistic/psychosocial aspects of care probably happens informally via mentoring and role modeling. Appeals to expand teaching in these areas raise questions regarding what to include in medical training and the proper scope of internal medicine. Sustainable change will depend on the politics of resource distribution and the influence of general internal medicine and primary care on traditional training.
authors.affiliation: St. Louis University School of Medicine, Missouri.
authors.forename: W T
authors.initials: WT
authors.lastname: Merkel
authors.forename: R B
authors.initials: RB
authors.lastname: Margolis
authors.forename: R C
authors.initials: RC
authors.lastname: Smith
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D006808:Humanism; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D010817:Physician-Patient Relations; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D014481:United States